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CDE0111

I 43 industry report _ IPS Empress Direct I cosmeticdentistry 1_2011 the tooth shape. A layering scheme was estab- lished before the treatment was begun. During the dental examination, the general preoperative situation, the natural colour of the patient’s teeth and individual characteristics were photographicallydocumented.Thelayeringscheme was prepared on the basis of the photographs. The different materials that would be used for the restoration were established in the process. In order to reproduce the special characteristics of the patient’s tooth anatomy, the appropriate dentine and enamel shades were selected along with an opalescent material and a white-opaque material (from the IPS Empress Direct range). At a second appointment, the operating field was isolated with a rubber dam, since absolute moisture control is indispensable in the placement of resin composites (Fig. 2). The outer margins of the old filling were traced with a pencil. This was done to highlight the transition between the filling and the tooth structure in the removal of the old filling. A small chamfer was prepared on the vestibular side, as this is indicated for this type of restoration (Fig. 3). Next, the enamel and dentine wereetchedwith37%phosphoricacid(TotalEtch) and a three-component adhesive (Syntac) was applied (Figs. 4 & 5). In order to obtain the desired tooth shade, the dentine part of the restoration was built up first with dentine material (IPS Empress Direct Dentin A2; Fig. 6). A translucent and opalescent material (Trans Opal from the IPS Empress Direct range) was usedtobuilduptheenamelpart(Fig.7).Thinwhite- opaque strips (IPS Empress Direct Bleach XL) were applied over the dentine segment to enhance the brightness.Finally,anappropriatelyshadedenamel material(IPSEmpressDirectEnamelA2)wasplaced over the entire facial surface of the restoration to coverallthepreviouslyplacedmaterials(Fig.8).The creation of surface texture as well as finishing and polishingareimportantworkingstepsinimparting a restoration with a true-to-nature appearance. As a result, they have to be given due attention. In the present case, the surface texture was created with diamond burs at low speed. This allowed the pro- cedure to be precisely controlled. A three-step sili- conepolishingsystem(Astropol)wasusedtofinish and polish the restoration. Finally, the restoration waspolishedtoahighglossfinishusingaluminium oxide, diamond pastes (Shiny System, Micerium), brushes and felt wheels. It is worthwhile recalling the patient for a third appointment to ensure that the restoration blends into the natural environment when the tooth is moistandtoestablishwhetheranyshapeorcolour adjustments need to be made (Fig. 9)._ Fig. 8 Fig. 9 Dr Anna Salat Vendrell C/ Frederic Corominas nº 48 Torrelles de Llobregat 08629 Barcelona Spain annasalat@hotmail.com cosmeticdentistry _contact Fig. 6 Fig. 7 Fig. 6_Application of the dentine material in the appropriate shade, that is, the appropriate translucency/opacity. Fig. 7_Application of the opalescent material in the enamel part of the tooth. Fig. 8_Application of the enamel material on the entire facial part of the restoration. Fig. 9_Restoration one week after it was placed.